LEGISLATURE URGED TO TIGHTEN CONTROLS ON IMPAIRED DOCTORS

By JOSEPH F. SULLIVAN

Published: December 20, 1987

TRENTON—
THE problem of protecting the public from incompetent doctors moved off the pages of a State Commission of Investigation report last week to a legislative hearing and should surface again in legislation next year.

James J. Morley, executive director of the S.C.I., set the tone of the hearing before the Senate Institutions, Health and Welfare Committee when he said:

''In essence, the commission's investigation fully confirmed that a 'conspiracy of silence' exists to evade moral and statutory obligations to report impaired or incompetent physicians to the State Board of Medical Examiners.''

Mr. Morley called the state's reporting statutes ''abysmally inadequate.'' This represents ''a very real threat to public safety,'' he said, since it allows too many impaired or otherwise incomptent doctors to continue practicing without adequate oversight or restriction.

The idea of a ''conspiracy of silence'' was called ''outrageous'' and a ''cheap shot at doctors'' by Herbert J. Stern, the former Federal District Court judge and United States Attorney for New Jersey, who has been retained by the Medical Society of New Jersey.

Members of the society who testified freely at closed S.C.I. hearings about the society's efforts to deal with problems of alcohol and drug abuse among physicians and to weed out incompetent physicians now believe they were treated unfairly in the commission's report.

''One incompetent doctor, from the doctors' point of view, is one too many,'' Mr. Stern said, adding that the medical society is a recognized national leader in dealing with the problem through its self-supported Impaired Physicians Program.

The commission made the same point in the preface to its report, but then detailed cases where the I.P.P. appeared to shield some doctors with serious drug problems from action by state licensing authorities, despite repeated lapses. Mr. Morley quoted from the text of the commission report that included testimony by Dr. David I. Canavan, director of the I.P.P. In the passage, Dr. Canavan is quoted as saying:

''The conspiracy of silence is people being afraid to report to anybody, even to us. People are afraid to report to us, a therapeutic program, because of the fear of anger or hostility . . . the fear of loss of friendship, fear of suit for libel or slander. There are all sorts of phantom doubts there.''

Senator Richard J. Codey, Democrat of West Orange and chairman of the Senate committee, said he had no doubts after the hearing last week that some legislation was needed, although he was not sure that a conspiracy existed.

However, he said that at least ''there is obviously a great reluctance on the part of doctors to report colleagues who are impaired or incompent.''

The S.C.I. report estimated that 3 to 16 percent of New Jersey's 28,766 doctors might be incompetent or impaired by drug abuse, alcoholism or other mental or physical illness.

Senator Codey said that the problem might go beyond the commission report.

''For example,'' he said, ''it's unbelievable to me that hospitals today are not reporting incompetent doctors to other hospitals where those same physicians are practicing.''

The report told of how some hospitals preferred to handle problem physicians within their own walls by furloughing them to get them out of their institutions, but then letting them go to some other hospital to continue practicing.

This allows the hospitals to avoid laws that mandate reporting to the Board of Medical Examiners, Mr. Morley said.

Mr. Codey said that hospitals that failed to alert other hospitals about physicians they had disciplined should be sanctioned.

He also noted that malpractice settlements of less than $25,000 did not have to be reported to the medical board. This means, he said, that thousands of such cases are never brought to the attention of the board, whose job it is to weed out incompetent physicians.

A package of bills aimed at addressing these reporting problems and increasing the staff of the medical board will be ready for introduction by the end of January, Senator Codey said.

Meantime, Mr. Stern said, the investigation commission has agreed to take additional testimony from the medical society and to give the problem ''another look.''